Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
3827141 | Progrès en Urologie | 2010 | 10 Pages |
Abstract
Local recurrence after external radiotherapy for prostate cancer occurs in 30Â to 50Â % and is often diagnosed by a rising PSA. The absence of local control after radiotherapy is a risk factor of metastases and specific mortality. There are several therapeutic options to treat these patients: surveillance, hormonotherapy and salvage therapies (radical prostatectomy, cystoprostatectomy, brachytherapy, high intensity focused ultrasound [HIFU] and cryotherapy). Hormonotherapy is not a curative treatment and after a couple of years, the disease will progress again. Local salvage therapies are the only treatment to have the potential to cure these patients with the condition of very strict inclusion criteria. Among these therapies, only radical prostatectomy demonstrated his efficacity with a follow-up of 10Â years on specific survival and survival without biological progession respectively from 70Â to 77Â % and from 30Â to 43Â %. During last decade, morbidity of RP has strongly decreased with a percentage of rectal and ureteral injury at 3Â %. Netherless, percentage of urinary incontinence remains high from 29Â to 50Â %. Salvage mini-invasive therapies (cryotherapy, HIFU and cryotherapy) are under constant evolution due to progress of technology. Functional and oncological results are better with last generation devices but need to be evaluated and compared with radical prostatectomy.
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Authors
P. Paparel, M. Soulie, P. Mongiat-Artus, F. Cornud, C. Borgogno, les membres du sous-comité prostate du CCAFU les membres du sous-comité prostate du CCAFU,